Surgery involves a complex set of manual tasks with numerous limitations, such as a surgeon's vision and manual dexterity. Enhanced vision allows a surgeon to have a clear visual comprehension of the surgical field and manual dexterity includes a surgeon's ability to manipulate surgical instruments without unnecessary restrictions. To enhance a surgeon's vision, optimal visualization and illumination have been the driving goals behind the development of microscopic surgery and endoscopic surgery. Despite numerous advances in visualization and illumination, however, current microscopic surgery techniques still fail to be minimally invasive. Endoscopic surgery, on the other hand, in addition to being minimally invasive, provides enhanced visualization and better illumination. Current intracranial endoscopic surgery, however, still significantly limits a surgeon's ability to perform manual tasks once proper visualization and illumination are achieved.
Conventional retractor systems used in surgery include self-retaining blade retractors (e.g. Greenberg, Budde, Sugita, etc.), handheld brain ribbon, endoscopy sheaths, and microendoscopic discectomy retractor. Numerous limitations of these systems exist. For example, the self-retaining blade retractors cause excessive brain retraction, allow bleeding into field (rundown), brain swelling, as well as limited visualization and illumination. The handheld brain ribbon, in addition to having the above disadvantages, has the obvious disadvantage of requiring to be handheld, thereby reducing a surgeon's manual dexterity. Endoscopic instruments have limited utility, particularly when they are used in neurosurgical procedures. Currently available designs limit the working channel to several millimeters. This renders the surgeon to performing surgery with probe-like instruments, and thus, current neuroendoscopic intracranial neurosurgery techniques are limited to procedures with only holes or fenestrations.
Furthermore, a microendoscopic discectomy retractor can only be used for spine surgery and its dilators are not suited for other types of surgeries, such as brain surgery, because it can damage brain tissues.
Therefore, it would be desirable to have a system and method that overcomes the disadvantages of the current retractor systems, while providing enhanced illumination and visualization without sacrificing a surgeon's manual dexterity, such as the ability to manipulate surgical instruments.